Healthcare Provider Details

I. General information

NPI: 1790603835
Provider Name (Legal Business Name): KAMEKO JOHNSON-STYLES LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3070 CURRENT WAY
LAUREL MD
20724-1811
US

IV. Provider business mailing address

3070 CURRENT WAY
LAUREL MD
20724-1811
US

V. Phone/Fax

Practice location:
  • Phone: 202-957-5616
  • Fax:
Mailing address:
  • Phone: 202-957-5616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number23110
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: